Unit #5B – Clinical Unit #5B – Clinical Laboratory TestingLaboratory TestingBasic HematologyBasic Hematology

Cecile Sanders, M.Ed., MLS(ASCP)Cecile Sanders, M.Ed., MLS(ASCP)

Unit #5B – Clinical Laboratory Unit #5B – Clinical Laboratory Testing – Basic HematologyTesting – Basic Hematology

Department of Hematology Department of Hematology – Study of formed elements of blood and Study of formed elements of blood and

blood forming tissuesblood forming tissues– Screen, diagnosis and monitor Screen, diagnosis and monitor

hematologic diseases (anemias, hematologic diseases (anemias, leukemias, etc.) and also give a general leukemias, etc.) and also give a general idea of overall healthidea of overall health

Unit #5B – Clinical Laboratory Unit #5B – Clinical Laboratory Testing – Basic HematologyTesting – Basic Hematology

Composition of Blood - blood is 6-8% of Composition of Blood - blood is 6-8% of total body weight and equals total body weight and equals approximately 5 liters (think about 5 liter approximately 5 liters (think about 5 liter bottles of Coke)bottles of Coke)– Serum vs Plasma – Serum vs Plasma –

Both are fluid portions of bloodBoth are fluid portions of blood Serum is from clotted blood, has no clotting Serum is from clotted blood, has no clotting

factors (used up in the clotting process)factors (used up in the clotting process) Plasma is from anticoagulated blood, has Plasma is from anticoagulated blood, has

clotting factors, makes up about 45-60% of clotting factors, makes up about 45-60% of blood’s volume blood’s volume

Unit #5B – Clinical Laboratory Unit #5B – Clinical Laboratory Testing – Basic HematologyTesting – Basic Hematology– Cellular Elements – make up the Cellular Elements – make up the

remainder of the blood volumeremainder of the blood volumeErythrocytes / RBCs Erythrocytes / RBCs

– ~ 4-6 million/µL~ 4-6 million/µL– Transport oxygen and carbon dioxideTransport oxygen and carbon dioxide

Electron Micrograph Stained Blood Smear Viewed by Electron Micrograph Stained Blood Smear Viewed by MicroscopeMicroscope

Unit #5B – Clinical Laboratory Unit #5B – Clinical Laboratory Testing – Basic HematologyTesting – Basic Hematology

Leukocytes / WBCs Leukocytes / WBCs – ~ 4,800-10,800 /µL in circulating blood; many ~ 4,800-10,800 /µL in circulating blood; many

more in tissuesmore in tissues– Function in immunity and defense against Function in immunity and defense against

bacteria, viruses and all other foreign materials bacteria, viruses and all other foreign materials (includes allergens like pollen, etc.)(includes allergens like pollen, etc.)

Illustration of WBC Stained WBC Viewed Under Illustration of WBC Stained WBC Viewed Under

MicroscopeMicroscope

Unit #5B – Clinical Laboratory Unit #5B – Clinical Laboratory Testing – Basic HematologyTesting – Basic Hematology

– Types of WBCs:Types of WBCs: Granulocytes (neutrophils, basophils, & Granulocytes (neutrophils, basophils, &

eosinophils) eosinophils)

DrawingDrawing Stained Granulocytes Viewed Under Stained Granulocytes Viewed Under MicroscopeMicroscope

Unit #5B – Clinical Laboratory Unit #5B – Clinical Laboratory Testing – Basic HematologyTesting – Basic Hematology

Lymphocytes (On blood smear)Lymphocytes (On blood smear)

Monocytes (On blood smear)Monocytes (On blood smear)

Unit #5B – Clinical Laboratory Unit #5B – Clinical Laboratory Testing – Basic HematologyTesting – Basic Hematology

Platelets / Thrombocytes Platelets / Thrombocytes – Pieces of a bone marrow cell known as a Pieces of a bone marrow cell known as a

megakaryocytemegakaryocyte– Function to stop bleeding by forming a plug and Function to stop bleeding by forming a plug and

also release coagulation factorsalso release coagulation factors

Platelets on blood smear (very small “dots” among Platelets on blood smear (very small “dots” among RBC)RBC)

Unit #5B – Clinical Laboratory Unit #5B – Clinical Laboratory Testing – Basic HematologyTesting – Basic Hematology

Common Hematology Laboratory Common Hematology Laboratory TestsTests– Complete Blood Count (CBC) includes:Complete Blood Count (CBC) includes:

RBC count RBC count WBC countWBC countHemoglobin Hemoglobin HematocritHematocritWBC DifferentialWBC DifferentialPlatelet countPlatelet countAdditional information on size and Additional information on size and

appearance of blood cellsappearance of blood cells

Unit #5B – Clinical Laboratory Unit #5B – Clinical Laboratory Testing – Basic HematologyTesting – Basic Hematology

Common Hematology Laboratory TestsCommon Hematology Laboratory Tests– Erythrocyte Sedimentation Rate (ESR)Erythrocyte Sedimentation Rate (ESR)– Reticulocyte CountReticulocyte Count– Sickle Cell TestingSickle Cell Testing– Coagulation Tests include:Coagulation Tests include:

Prothrombin Time (PT)Prothrombin Time (PT)Partial Thromboplastin Time (PTT)Partial Thromboplastin Time (PTT)FibrinogenFibrinogenFactor AnalysisFactor Analysis

Unit #5B – Clinical Laboratory Unit #5B – Clinical Laboratory Testing – Basic HematologyTesting – Basic Hematology

Hematological Diseases Hematological Diseases (Diseases may be classified in (Diseases may be classified in more than one category)more than one category)

– Diseases of improper or insufficient productionDiseases of improper or insufficient production Anemias – Examples include iron deficiency Anemias – Examples include iron deficiency

anemia and aplastic anemia, among othersanemia and aplastic anemia, among others Leukemias – WBC production is affected and Leukemias – WBC production is affected and

defective. Examples include acute and chronic defective. Examples include acute and chronic leukemiasleukemias

Thrombocytopenia – Decreased platelets. Thrombocytopenia – Decreased platelets. Patient may have bleeding problemsPatient may have bleeding problems

Unit #5B – Clinical Laboratory Unit #5B – Clinical Laboratory Testing – Basic HematologyTesting – Basic Hematology– Diseases of defective cell function Diseases of defective cell function

May be combination of improper cell production and May be combination of improper cell production and defective functiondefective function

Examples include iron deficiency anemia and certain Examples include iron deficiency anemia and certain leukemiasleukemias

– Inherited hematological diseases Inherited hematological diseases Examples include hemophilia, sickle cell anemia, Examples include hemophilia, sickle cell anemia,

G6PD deficiency, thalassemiasG6PD deficiency, thalassemias

– Secondary or acquired hematological diseases Secondary or acquired hematological diseases Examples include hemolytic disease due to renal Examples include hemolytic disease due to renal

pathologies or atypical lymphocytes due to viral pathologies or atypical lymphocytes due to viral infectionsinfections